Combinational liposome compositions for cancer therapy

ABSTRACT

The present invention provides methods for delivery of therapeutic agents to a subject using multi-component liposomal systems. The methods include administration of a therapeutic liposome containing an active agent, followed by a administration of an attacking liposome that induces release of the agents from the therapeutic liposome.

CROSS-REFERENCES TO RELATED APPLICATIONS

This patent application is a continuation of U.S. patent applicationSer. No. 15/162,072, filed on May 23, 2016, which is a continuation ofU.S. patent application Ser. No. 13/664,457, filed on Oct. 31, 2012,which claims priority to U.S. Provisional Application Ser. No.61/553,786, filed Oct. 31, 2011, which are incorporated herein byreference in their entirety to the full extent permitted by law.

STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSOREDRESEARCH AND DEVELOPMENT

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REFERENCE TO A “SEQUENCE LISTING,” A TABLE, OR A COMPUTER PROGRAMLISTING APPENDIX SUBMITTED ON A COMPACT DISK

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BACKGROUND OF THE INVENTION

Liposomes can be used as effective drug delivery vehicles, andcommercially available liposomal products have been developed fortreatment of diseases including cancer (Barenholz, Y., Curr. Opin. inColloid & Interface Sci. 6(1): 66-77 (2001)). A liposome is a vesicleincluding at least one phospholipid bilayer separating an interioraqueous phase from the external aqueous environment. A liposome iscapable of carrying both hydrophobic cargo in the lipid bilayer and/orhydrophilic cargo in the aqueous core. Liposome size is usually in arange from 50 to 250 nm, which is particularly suitable for targeteddelivery of chemotherapy agents to solid tumor sites via the enhancedpermeability and retention of cancer tissues (the EPR effect) (Maeda,H., et al., J. Controlled Release. 65(1-2): 271 (2000)). Thepreferential accumulation of drug-containing liposomes at the tumor sitevia EPR provides a means for localizing the drug, improving drugefficacy, and reducing drug toxicity to normal cells or tissues. Forexample, Doxil™, an FDA-approved liposome product containingdoxorubicin, has been shown to have reduced toxicity compared with thefree drug (Martin, F. J., et al., “Clinical pharmacology and antitumorefficacy of DOXIL.” Medical Applications of Liposornes. Ed. D. D. Lasic.Amsterdam: Elsevier, 1998, pp 635-688).

However, the benefits of liposomal drug delivery vehicles are limited bydrawbacks including liposome metabolism and excretion from the body, aswell as a certain level of intrinsic toxicity and side effects due tosystemic distribution and delivery. In particular, optimizing therelease rate of liposomal drug is a difficult balancing act between invivo half life and release. In general, leaky liposomes will make theencapsulated drug more available, but cause more risk in toxicitysimilar to the free drug. On the other hand, less leaky liposomes mayreduce toxicity, but they may not provide the desirable drug release forefficacy as shown in a cisplatin preparation (SPI-077) (Kim, E. S. etal., Lung Cancer. 34(3): 427-432 (2001)). Therefore, balancing efficacyand safety in the development and administration of liposomal drugproducts constitutes a significant challenge.

Accordingly, there is a need to develop formulations and deliverymethods which overcome the limitations of therapies based on singularliposomal preparations. The present invention addresses this and otherneeds, providing a means of improving drug safety and efficacy.

BRIEF SUMMARY OF THE INVENTION

In one aspect, the present invention provides a method for delivering atherapeutic agent to a subject, the method comprising:

-   -   a) administering to the subject a liposome comprising a        therapeutic agent; and    -   b) administering to the subject a lipid nanoparticle comprising        a triggering agent;        whereby release of the therapeutic agent from the liposome        following administration of the lipid nanoparticle is increased,        compared to the release of the therapeutic agent from the        liposome without administration of the lipid nanoparticle.

In a second aspect, the invention provides a kit for delivering atherapeutic agent to a subject, the kit comprising:

-   -   a) a first composition comprising a liposome containing a        therapeutic agent; and    -   b) a second composition comprising a lipid nanoparticle        containing a non-ionic triggering agent;        wherein the first and second compositions are stored separately        prior to administration to the subject.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows oxaliplatin release from therapeutic liposomes triggered byattacking liposome 4460-075 at (a) pH=5.0 and (b) pH=7.4.

FIG. 2 shows cisplatin release from therapeutic liposomes triggered byvarying amounts of attacking liposome 4460-075 at (a) pH=7.4 and (b)pH=5.

FIG. 3 shows the release of 5-carboxyfluorescein (5-CF) from therapeuticliposome Part A (4460-090) by adding attacking liposome Part B(4460-075) at pH=7.4.

FIG. 4 shows the release of 5-CF from liposome Part A (4460-077) bymixing with liposome Part B (4460-075).

FIG. 5 shows the release of 5-CF from liposome Part A (4386-143) bymixing with liposome Part B (4460-075) at pH=7.4.

FIG. 6 shows the release of 5-CF from liposome Part A (4460-090) bymixing with liposome Part B (4460-084) at pH=7.4.

FIG. 7 shows the release of 5-CF from liposome Part A (4460-077) bymixing with liposome Part B (4460-084) at pH=7.4.

FIG. 8 shows the release of 5-CF from liposome Part A (4460-090) bymixing with liposome Part B (4384-086) at pH=7.4.

FIG. 9 shows the release of 5-CF from liposome Part A (4460-077) bymixing with liposome Part B (4384-086) at pH=7.4.

FIG. 10 shows the release of 5-CF from liposome Part A (4460-090) bymixing with liposome Part B (4460-075) at pH=5.0.

FIG. 11 shows the release of oxaliplatin from liposome (NLICOV003F-02)by adding attacking liposome 4460-104 at pH=7.4 and pH=5.0.

FIG. 12 shows the release of cisplatin from therapeutic liposomes (NLI4481101) by adding attacking liposomes (4460-104) at (a) pH=5.0 and (b)pH=7.4.

DETAILED DESCRIPTION OF THE INVENTION I. General

The present invention relates to the use of multiple lipid compositionsfor delivery of drugs or other agents to a subject. The methods of theinvention include the administration of separate lipid compositionsincluding a therapeutic liposome and an attacking agent. The therapeuticliposome is a liposomal component containing a therapeutic agent and/orother agents (e.g., diagnostic agents). The attacking agent is a lipidnanoparticle (a liposome, a micelle, or a mixture thereof) containing atriggering agent which can increase the release of cargo from thetherapeutic liposome. In the present context, the terms “attackingagent” and “lipid nanoparticle containing a triggering agent” are usedinterchangeably. In some embodiments, the therapeutic liposome and theattacking agent are collectively referred to as a “dualsome.” The twocomponents can be stored separately, and the attacking agent can beadministered following administration of the therapeutic liposome inorder to effect a regulated delivery of the therapeutic liposome'scargo. The methods of the invention include two steps: 1) administrationof the therapeutic liposome, and 2) administration of the attackingagent to trigger an increase in drug release from the therapeuticliposomes relative to the release in the absence of the attacking agent.The methods of the invention can prevent the early release of agentsfrom the therapeutic liposome before it reaches a target site within asubject. The methods overcome the current dilemma of using a singularliposomal preparation for drug delivery, thus improving therapeuticefficacy and safety as well as patient compliance.

II. Definitions

As used herein, the terms “delivery” and “delivering” refer toconveyance of a therapeutic agent to a subject using the methods of theinvention. Delivery may be localized to a particular location in asubject, such as a tissue, an organ, or cells of a particular type.

As used herein, the term “therapeutic agent” refers to a compound ormolecule that, when present in an effective amount, produces a desiredtherapeutic effect on a subject in need thereof. The present inventioncontemplates a broad range of therapeutic agents and their use inconjunction with the liposome compositions, as further described herein.

As used herein, the term “subject” refers to any mammal, in particular ahuman, at any stage of life.

As used herein, the terms “administer,” “administered,” or“administering” refer to methods of administering the liposomecompositions of the present invention. The liposome compositions of thepresent invention can be administered in a variety of ways, includingtopically, parenterally, intravenously, intradermally, intramuscularly,colonically, rectally or intraperitoneally. The liposome compositionscan also be administered as part of a composition or formulation.

As used herein, the term “liposome” encompasses any compartment enclosedby a lipid bilayer. The term liposome includes unilamellar vesicleswhich are comprised of a single lipid bilayer and generally have adiameter in the range of about 20 to about 400 nm. Liposomes can also bemultilamellar, which generally have a diameter in the range of 1 to 10pm. In some embodiments, liposomes can include multilamellar vesicles(MLV), large unilamellar vesicles (LUV), and small unilamellar vesicles(SUV).

As used herein, the term “micelle” refers to an aggregate of amphiphilicmolecules such as lipids, assembled so as to form a particle with ahydrophobic interior and a hydrophilic exterior. Micelles are generallyspherical assemblies with diameters below 100 nm, although a range ofmicelle diameters and varying micelle shapes, such as discoid micelles,are known in the art.

As used herein, the term “non-ionic triggering agent” refers to asubstance lacking charged functional groups, including anionicfunctional groups and cationic functional groups, which uponadministration to a subject causes an increase in the release of drugcargo from the therapeutic liposome of the invention. Examples ofnon-ionic triggering agents include TPGS and polyoxyethylene 40steareate.

As used herein, the term “accumulated” refers to liposomes that haveamassed at a given site in a subject after administration, having ceasedto systemically circulate within the subject. In some cases, theaccumulation may be due to binding of a specific biomarker at the targetsite by a liposome comprising a ligand that recognizes the biomarker. Insome cases, the liposome accumulation may be due to the enhancedpermeability and retention characteristics of certain tissues such ascancer tissues. Liposome accumulation may be assessed by any suitablemeans, such as compartmental analysis of test subjects or non-invasivetechniques such as single photon emission computer tomography (SPECT),positron emission tomography (PET) or nuclear magnetic resonance imaging(NMR/MRI). However, one of skill in the art can plan the timing ofliposome administration to a particular subject so as to allow forsufficient accumulation at a target site without directly measuringaccumulation in the subject.

As used herein, the term “target site” refers to a location at whichliposome accumulation and delivery of an active agent is desired. Insome cases, the target site can be a particular tissue or cell and maybe associated with a particular disease state.

As used herein, the term “contact” refers to interaction of a firstliposome with a second liposome so as to destabilize the first liposomeor otherwise effect release of the encapsulated agents from the firstliposome.

As used herein, the term “release” refers to the movement of an activeagent in a liposome from the liposome core or lipid bilayer to theexternal environment.

As used herein, the term “lipid” refers to lipid molecules that caninclude fats, waxes, steroids, cholesterol, fat-soluble vitamins,monoglycerides, diglycerides, phospholipids, sphingolipids, glycolipids,cationic or anionic lipids, derivatized lipids, and the like, asdescribed in detail below. Lipids can form micelles, monolayers, andbilayer membranes. The lipids can self-assemble into liposomes.

As used herein, the terms “molar percentage” and “mol %” refer to thenumber of a moles of a given lipid or surfactant component of a liposomedivided by the total number of moles of all lipid or surfactantcomponents. Unless explicitly stated, the amounts of active agents,diluents, or other components are not included when calculating the mol% for a lipid or surfactant component of a liposome.

As used herein, the term “kit” refers to a set of two or more componentsnecessary for employing the methods of the invention. Kit components caninclude, but are not limited to, liposomes of the present invention,reagents, buffers, containers and/or equipment.

As used herein, the phrase “stored separately” refers to a manner ofliposome storage that prevents a first population of liposomes fromcontacting another population of liposomes.

III. Embodiments of the Invention

In one aspect, the present invention provides a method for delivering atherapeutic agent to a subject. The method includes: a) administering tothe subject a liposome comprising a therapeutic agent; and b)administering to the subject a lipid nanoparticle comprising a non-ionictriggering agent; whereby release of the therapeutic agent from theliposome after administration of the triggering agent is increased ascompared to the release of the therapeutic agent from the liposomewithout administration of the triggering agent. The liposome comprisinga therapeutic agent is referred to as a “therapeutic liposome.”

The liposomes of the present invention comprise an aqueous compartmentenclosed by at least one lipid bilayer. When lipids that include ahydrophilic headgroup are dispersed in water they can spontaneously formbilayer membranes referred to as lamellae. The lamellae are composed oftwo monolayer sheets of lipid molecules with their non-polar(hydrophobic) surfaces facing each other and their polar (hydrophilic)surfaces facing the aqueous medium. The term liposome includesunilamellar vesicles which are comprised of a single lipid bilayer andgenerally have a diameter in the range of about 20 to about 400 nm,about 50 to about 300 nm, or about 100 to 200 nm. Liposomes can also bemultilamellar, which generally have a diameter in the range of 1 to 10μm with anywhere from two to hundreds of concentric lipid bilayersalternating with layers of an aqueous phase. In some embodiments,liposomes can include multilamellar vesicles (MLV), large unilamellarvesicles (LUV), and small unilamellar vesicles (SUV). The lipids of theliposome can be cationic, zwitterionic, neutral or anionic, or anymixture thereof.

The lipid nanoparticle constitutes the “attacking agent” in the methodsof the present invention. In some embodiments, the lipid nanoparticle isselected from a liposome, a micelle, or mixtures thereof. Thenanoparticle contains a non-ionic triggering agent, which can be anon-ionic surfactant. Examples of non-surfactants suitable for use inthe methods of the invention include, but are not limited to, anethoxylated alkylphenol, an ethoxylated fatty ester, a sorbitanderivative, a tocopherol derivative, and the like.

Administration of the attacking agent to a subject can occur at any timesufficient to increase the release of the therapeutic agent from thetherapeutic liposome. In some embodiments, the attacking agent isadministered to the subject after administration of the therapeuticliposome. Administration of the attacking agent can occur, for example,a few minutes or several hours after administration of the therapeuticliposome. In some embodiments, the attacking agent is administered tothe subject after the therapeutic liposome has accumulated at a desiredtarget site within the subject (typically within about 72 hours afteradministration). Liposome accumulation at a target site may be assessedby any suitable means, such as compartmental analysis of test subjectsor non-invasive techniques such as single photon emission computertomography (SPECT), positron emission tomography (PET) or nuclearmagnetic resonance imaging (NMR/MRI). Diagnostic agents as describedbelow, for example, may be chosen for incorporation in the therapeuticliposomes for assessment of liposome accumulation. However, one of skillin the art will appreciate that administration to a particular subjectcan be timed so as to allow for sufficient accumulation of therapeuticliposomes at a target site without directly measuring accumulation inthe subject.

In some embodiments, release of the therapeutic agent is induced uponcontact of the therapeutic liposome by the attacking agent. The amountof therapeutic agent released from the liposome can increase by anyamount with administration of the attacking agent as compared to in theabsence of the attacking agent. In some embodiments, administration ofthe attacking agent causes at least a 3-fold increase in release of thetherapeutic agent from the liposome, as compared to administration ofthe liposome without the attacking agent. In some embodiments,administration of the attacking agent causes at least a 10-fold increasein release of the therapeutic agent from the liposome, as compared toadministration of the liposome without the attacking agent. In someembodiments, administration of the attacking agent causes at least a25-fold increase in release of the therapeutic agent from the liposome,as compared to administration of the liposome without the attackingagent.

In the present invention, the subject can be any mammal. In someembodiments, the subject is human. In some embodiments, the liposome andthe lipid nanoparticle are delivered by intraperitoneal injection. Oneof skill in the art will appreciate that other modes of administrationmay be useful in the present invention.

Liposomes and Lipid Nanoparticles

The liposomes and lipid nanoparticles of the present invention cancontain any suitable lipid, including cationic lipids, zwitterioniclipids, neutral lipids, or anionic lipids as described above. Suitablelipids can include fats, waxes, steroids, cholesterol, fat-solublevitamins, monoglycerides, diglycerides, phospholipids, sphingolipids,glycolipids, cationic or anionic lipids, derivatized lipids, and thelike.

Suitable phospholipids include but are not limited tophosphatidylcholine (PC), phosphatidic acid (PA),phosphatidylethanolamine (PE), phosphatidylglycerol (PG),phosphatidylserine (PS), and phosphatidylinositol (P1), dimyristoylphosphatidyl choline (DMPC), distearoyl phosphatidyl choline (DSPC),dioleoyl phosphatidyl choline (DOPC), dipalmitoyl phosphatidyl choline(DPPC), dimyristoyl phosphatidyl glycerol (DMPG), distearoylphosphatidyl glycerol (DSPG), dioleoyl phosphatidyl glycerol (DOPG),dipalmitoyl phosphatidyl glycerol (DPPG), dimyristoyl phosphatidylserine (DMPS), distearoyl phosphatidyl serine (DSPS), dioleoylphosphatidyl serine (DOPS), dipalmitoyl phosphatidyl serine (DPPS),dioleoyl phosphatidyl ethanolamine (DOPE),palmitoyloleoylphosphatidylcholine (POPC),palmitoyloleoyl-phosphatidylethanolamine (POPE) anddioleoyl-phosphatidylethanolamine4-(N-maleimidomethyl-cyclohexane-1-carboxylate (DOPE-mal), dipalmitoylphosphatidyl ethanolamine (DPPE), dimyristoylphosphoethanolamine (DMPE),distearoyl-phosphatidylethanolamine (DSPE), 16-O-monomethyl PE,16-O-dimethyl PE, 18-1-trans PE,1-stearoyl-2-oleoyl-phosphatidyethanolamine (SOPE),1,2-dielaidoyl-sn-glycero-3-phophoethanolamine (transDOPE), andcardiolipin. Lipid extracts, such as egg PC, heart extract, brainextract, liver extract, and soy PC, are also useful in the presentinvention. In some embodiments, soy PC can include Hydro Soy PC (HSPC).In certain embodiments, the lipids can include derivatized lipids, suchas PEGylated lipids. Derivatized lipids can include, for example,DSPE-PEG2000, cholesterol-PEG2000, DSPE-polyglycerol, or otherderivatives generally known in the art.

Liposomes and lipid nanoparticles of the present invention may containsteroids, characterized by the presence of a fused, tetracyclic gonanering system. Examples of steroids include, but are not limited to,cholesterol, cholic acid, progesterone, cortisone, aldosterone,estradiol, testosterone, dehydroepiandrosterone. Synthetic steroids andderivatives thereof are also contemplated for use in the presentinvention.

Cationic lipids contain positively charged functional groups underphysiological conditions. Cationic lipids include, but are not limitedto, N,N-dioleyl-N,N-dimethylammonium chloride (DODAC),N,N-distearyl-N,N-dimethylammonium bromide (DDA13),N-(1-(2,3-dioleoyloxy)propyl)-N,N,N-trimethylammonium chloride (DOTAP),N-(1-(2,3-dioleoyloxy)propyl)-N,N,N-trimethylammonium chloride (DOTMA),N-[1-(2,3-ditetradecyloxy)propyl]-N,N-dimethyl-N-hydroxyethylammoniumbromide (DMRIE), N-[1-(2,3,dioleyloxy)propyl]-N,N-dimethyl-N-hydroxyethylammonium bromide (DORIE), 3B—[N—(N′,N′-dimethylaminoethane)carbamoyl]cholesterol (DC-Chol), dimethyldioctadecylammonium (DDAB) andN,N-dimethyl-2,3-dioleyloxy)propylamine (DODMA).

In some embodiments, the therapeutic liposome includes one or morelipids which can be a phospholipid, a steroid, and/or a cationic lipid.In some embodiments, the phospholipid is a phosphatidylcholine, aphosphatidylglycerol, a phosphatidylethanolamine, a phosphatidylserine,a phosphatidylinositol, or a phosphatidic acid. In some embodiments, thephosphatidylcholine is DSPC. In some embodiments, thephosphatidylglycerol is DSPG. In some embodiments, thephosphatidylethanolamine is DSPE-PEG(2000). In some embodiments, thesteroid is cholesterol.

As described above, the lipid nanoparticle constituting the “attackingagent” is selected from the group of consisting of a second liposome, amicelle, or mixtures thereof. In some embodiments, the lipidnanoparticle is a second liposome. The second liposome is referred to asan “attacking liposome.” In some embodiments, the attacking liposomecomprises one or more lipids selected from the group consisting of aphospholipid, a steroid, and a cationic lipid. In some embodiments, thephospholipid is a phosphatidylcholine, a phosphatidylglycerol, aphosphatidylethanolamine, a phosphatidylserine, a phosphatidylinositol,or a phosphatidic acid. In some embodiments, the phosphatidylcholine isDPPC. In some embodiments, the steroid is cholesterol. In someembodiments, the cationic lipid is DOTAP. In some embodiments, thenon-ionic triggering agent is TPGS.

Any suitable combination of lipids can be used to provide the liposomesand lipid nanoparticles of the invention. The lipid compositions can betailored to affect characteristics such as leakage rates, stability,particle size, zeta potential, protein binding, in vivo circulation,and/or accumulation in tissues or organs. For example, DSPC and/orcholesterol can be used to decrease leakage from liposomes. Negativelyor positively lipids, such as DSPG and/or DOTAP, can be included toaffect the surface charge of a liposome or lipid nanoparticle. In someembodiments, the lipid compositions can include about ten or fewer typesof lipids, or about five or fewer types of lipids, or about three orfewer types of lipids. In some embodiments, the molar percentage (mol %)of a specific type of lipid present typically comprises from about 0% toabout 10%, from about 10% to about 30%, from about 30% to about 50%,from about 50% to about 70%, from about 70% to about 90%, from about 90%to 100% of the total lipid present in a liposome or lipid nanoparticle.In some embodiments, the therapeutic liposome comprises 40-80 mol %DSPC, 5-50 mol % cholesterol, 0-30 mol % DSPG, and 0-10 mol %DSPE-PEG(2000). In some embodiments, the attacking liposome comprises40-70 mol % DPPC, 5-20 mol % cholesterol, 0-20 mol % DOTAP, and 20-40mol % TPGS.

The lipid nanoparticles of the invention can contain surfactantsincluding non-ionic surfactants, some of which can act as triggeringagents to facilitate release of the therapeutic liposome's cargo.Examples of non-ionic surfactants include, but are not limited to,ethoxylated alkylphenols, ethoxylated fatty esters, sorbitanderivatives, and tocopherol derivatives. Surfactants contemplated foruse in the present invention include D-α-tocopherol polyethylene glycolsuccinate (TPGS), which is available having different polyethyleneglycol sizes. In some embodiments, the molecular weight range forpolyethylene glycol in TPGS is 400-5000. In still other embodiments, themolecular weight range for polyethylene glycol in TPGS is 800-2000. Inyet other embodiments, the molecular weight range for polyethyleneglycol in TPGS is 800-1500. One particularly useful TPGS is TPGS(1000),in which to total molecular weight of the D-α-tocopherol polyethyleneglycol succinate is about 1543. As used herein, the term “TPGS” refersto TPGS(1000) unless a different size/weight is provided. Other usefulnon-ionic surfactants include: polyethylene glycolp-(1,1,3,3-tetramethylbutyl)-phenyl ether, polyoxyethylene (2)isooctylphenyl ether, polyoxyethylene (150) dinonylphenyl ether,dodecanoic acid 2,3-dihydroxypropyl ester, polyoxyethylene (20) sorbitanmonolaurate, polyoxyethylene (20) sorbitan monopalmitate,polyoxyethylene (20) sorbitan monostearate, polyoxyethylene (20)sorbitan monooleate, and the like.

One of skill in art will recognize that the lipid compositions may beadjusted to modulate the release properties or other characteristics ofthe liposomes as required by a given application.

Therapeutic Agents

The therapeutic liposomes of the present invention comprise one or moretherapeutic agents present anywhere in, on, or around the nanocarrier.For example, a therapeutic agent be embedded in the lipid bilayer of theliposome, encapsulated in the aqueous core of the liposome, or tetheredto the exterior of the liposome. The therapeutic agent or agents used inthe present invention can include any agent directed to treat acondition in a subject. In general, any therapeutic agent known in theart can be used, including without limitation agents listed in theUnited States Pharmacopeia (U.S.P.), Goodman and Gilman's ThePharmacological Basis of Therapeutics, 10^(th) Ed., McGraw Hill, 2001;Katzung, Ed., Basic and Clinical Pharmacology, McGraw-Hill/Appleton &Lange, 8^(th) ed., Sep. 21, 2000; Physician's Desk Reference (ThomsonPublishing; and/or The Merck Manual of Diagnosis and Therapy, 18^(th)ed., 2006, Beers and Berkow, Eds., Merck Publishing Group; or, in thecase of animals, The Merck Veterinary Manual, 9th ed., Kahn Ed., MerckPublishing Group, 2005; all of which are incorporated herein byreference.

Therapeutic agents can be selected depending on the type of diseasedesired to be treated. For example, certain types of cancers or tumors,such as carcinoma, sarcoma, leukemia, lymphoma, myeloma, and centralnervous system cancers as well as solid tumors and mixed tumors, caninvolve administration of the same or possibly different therapeuticagents. In certain embodiments, a therapeutic agent can be delivered totreat or affect a cancerous condition in a subject and can includechemotherapeutic agents, such as alkylating agents, antimetabolites,anthracyclines, alkaloids, topoisomerase inhibitors, and otheranticancer agents. In some embodiments, the agents can include antisenseagents, microRNA, siRNA and/or shRNA agents.

Therapeutic agents can include an anticancer agent or cytotoxic agentincluding but not limited to avastin, doxorubicin, cisplatin,oxaliplatin, carboplatin, 5-fluorouracil, gemcitibine or taxanes, suchas paclitaxel and docetaxel. Additional anti-cancer agents can includebut are not limited to 20-epi-1,25 dihydroxyvitamin D3,4-ipomeanol,5-ethynyluracil, 9-dihydrotaxol, abiraterone, acivicin, aclarubicin,acodazole hydrochloride, acronine, acylfulvene, adecypenol, adozelesin,aldesleukin, all-tk antagonists, altretamine, ambamustine, ambomycin,ametantrone acetate, amidox, amifostine, aminoglutethhnide,aminolevulinic acid, amrubicin, amsacrine, anagrelide, anastrozole,andrographolide, angiogenesis inhibitors, antagonist D, antagonist G,antarelix, anthramycin, anti-dorsalizing morphogenetic protein-1,antiestrogen, antineoplaston, antisense oligonucleotides, aphidicolinglycinate, apoptosis gene modulators, apoptosis regulators, apurinicacid, ARA-CDP-DL-PTBA, arginine deaminase, asparaginase, asperlin,asulacrine, atamestane, atrimustine, axinastatin 1, axinastatin 2,axinastatin 3, azacitidine, azasetron, azatoxin, azatyrosine, azetepa,azotomycin, baccatin III derivatives, balanol, batimastat,benzochlorins, benzodepa, benzoylstaurosporine, beta lactam derivatives,beta-alethine, betaclamycin B, betulinic acid, BFGF inhibitor,bicalutamide, bisantrene, bisantrene hydrochloride,bisaziridinylspermine, bisnafide, bisnafide dimesylate, bistratene A,bizelesin, bleomycin, bleomycin sulfate, BRC/ABL antagonists, breflate,brequinar sodium, bropirimine, budotitane, busulfan, buthioninesulfoximine, eactinomycin, caleipotriol, calphostin C, calusterone,camptothecin derivatives, canarypox IL-2, capecitabine, caracemide,carbetimer, carboplatin, carboxamide-amino-triazole,carboxyamidotriazole, carest M3, carmustine, cam 700, cartilage derivedinhibitor, carubicin hydrochloride, carzelesin, casein kinaseinhibitors, castanospermine, cecropin B, cedefingol, cetrorelix,chlorambucil, chlorins, chloroquinoxaline sulfonamide, cicaprost,cirolemycin, cisplatin, cis-porphyrin, cladribine, clomifene analogs,clotrimazole, collismycin A, collismycin B, combretastatin A4,combretastatin analog, conagenin, crambescidin 816, crisnatol, crisnatolmesylate, cryptophycin 8, cryptophycin A derivatives, curacin A,cyclopentanthraquinones, cyclophosphamide, cycloplatam, cypemycin,cytarabine, cytarabine ocfosfate, cytolytic factor, cytostatin,dacarbazine, dacliximab, dactinomyein, daunorubicin hydrochloride,decitabine, dehydrodidemnin B, deslorelin, dexifosfamide, dexormaplatin,dexrazoxane, dexverapamil, dezaguanine, dezaguanine mesylate,diaziquone, didemnin B, didox, diethylnorspermine,dihydro-5-azacytidine, dioxamycin, diphenyl spiromustine, docetaxel,docosanol, dolasetron, doxifluridine, doxorubicin, doxorubicinhydrochloride, droloxifene, droloxifene citrate, dromostanolonepropionate, dronabinol, duazomycin, duocarrnycin SA, ebselen,ecomustine, edatrexate, edelfosine, edrecolomab, eflomithine,eflomithine hydrochloride, elemene, elsamitrucin, emitefur, enloplatin,enprornate, epipropidine, epirubicin, epirubicin hydrochloride,epristeride, erbulozole, erythrocyte gene therapy vector system,esorubicin hydrochloride, estramustine, estramustine analog,estramustine phosphate sodium, estrogen agonists, estrogen antagonists,etanidazole, etoposide, etoposide phosphate, etoprine, exemestane,fadrozole, fadrozole hydrochloride, fazarabine, fenretinide, filgrastim,finasteride, flavopiridol, flezelastine, floxuridine, fluasterone,fludarabine, fludarabine phosphate, fluorodaunorunicin hydrochloride,fluorouracil, fluorocitabine, forfenimex, fonnestane, fosquidone,fostriecin, fostriecin sodium, fotemustine, gadolinium texaphyrin,gallium nitrate, galocitabine, ganirelix, gelatinase inhibitors,gemcitabine, gemcitabine hydrochloride, glutathione inhibitors,hepsulfam, heregulin, hexamethylene bisacetamide, hydroxyurea,hypericin, ibandronic acid, idarubicin, idarubicin hydrochloride,idoxifene, idramantone, ifosfamide, ilmofosine, ilomastat,imidazoacridones, imiquimod, immunostimulant peptides, insulin-likegrowth factor-1 receptor inhibitor, interferon agonists, interferonalpha-2A, interferon alpha-2B, interferon alpha-N1, interferon alpha-N3,interferon beta-IA, interferon gamma-IB, interferons, interleukins,iobenguane, iododoxorubicin, iproplatin, irinotecan, irinotecanhydrochloride, iroplact, irsogladine, isobengazole, isohornohalicondrinB, itasetron, jasplakinolide, kahalalide F, lamellarin-N triacetate,lanreotide, lanreotide acetate, leinamycin, lenograstim, lentinansulfate, leptolstatin, letrozole, leukemia inhibiting factor, leukocytealpha interferon, leuprolide acetate, leuprolide/estrogen/progesterone,leuprorelin, levamisole, liarozole, liarozole hydrochloride, linearpolyamine analog, lipophilic disaccharide peptide, lipophilic platinumcompounds, lissoclinamide 7, lobaplatin, lombricine, lometrexol,lometrexol sodium, lomustine, lonidamine, losoxantrone, losoxantronehydrochloride, lovastatin, loxoribine, lurtotecan, lutetium texaphyrin,lysofylline, lytic peptides, maitansine, mannostatin A, marimastat,masoprocol, maspin, matrilysin inhibitors, matrix metalloproteinaseinhibitors, maytansine, mechlorethamine hydrochloride, megestrolacetate, melengestrol acetate, melphalan, menogaril, merbarone,mercaptopurine, meterelin, methioninase, methotrexate, methotrexatesodium, metoclopramide, metoprine, meturedepa, microalgal protein kinaseC inhibitors, MIF inhibitor, mifepristone, miltefosine, mirimostim,mismatched double stranded RNA, mitindomide, mitocarcin, mitocromin,mitogillin, mitoguazone, mitolactol, mitomalcin, mitomycin, mitomycinanalogs, mitonafide, mitosper, mitotane, mitotoxin fibroblast growthfactor-saporin, mitoxantrone, mitoxantrone hydrochloride, mofarotene,molgramostim, monoclonal antibody, human chorionic gonadotrophin,monophosphoryl lipid a/myobacterium cell wall SK, mopidamol, multipledrug resistance gene inhibitor, multiple tumor suppressor 1-basedtherapy, mustard anticancer agent, mycaperoxide B, mycobacterial cellwall extract, mycophenolic acid, myriaporone, n-acetyldinaline,nafarelin, nagrestip, naloxone/pentazocine, napavin, naphterpin,nartograstim, nedaplatin, nemorubicin, neridronic acid, neutralendopeptidase, nilutamide, nisamycin, nitric oxide modulators, nitroxideantioxidant, nitrullyn, nocodazole, nogalamycin, n-substitutedbenzamides, 06-benzylguanine, octreotide, okicenone, oligonucleotides,onapristone, ondansetron, oracin, oral cytokine inducer, orinaplatin,osaterone, oxaliplatin, oxaunomycin, oxisuran, paclitaxel, paclitaxelanalogs, paclitaxel derivatives, palauamine, palmitoylrhizoxin,pamidronic acid, panaxytriol, panomifene, parabactin, pazelliptine,pegaspargase, peldesine, peliomycin, pentamustine, pentosan polysulfatesodium, pentostatin, pentrozole, peplomycin sulfate, perflubron,perfosfamide, perillyl alcohol, phenazinomycin, phenylacetate,phosphatase inhibitors, picibanil, pilocarpine hydrochloride,pipobroman, piposulfan, pirarubicin, piritrexim, piroxantronehydrochloride, placetin A, placetin B, plasminogen activator inhibitor,platinum complex, platinum compounds, platinum-triamine complex,plicamycin, plomestane, porfimer sodium, porfiromycin, prednimustine,procarbazine hydrochloride, propyl bis-acridone, prostaglandin J2,prostatic carcinoma antiandrogen, proteasome inhibitors, protein A-basedimmune modulator, protein kinase C inhibitor, protein tyrosinephosphatase inhibitors, purine nucleoside phosphorylase inhibitors,puromycin, puromycin hydrochloride, purpurins, pyrazofurin,pyrazoloacridine, pyridoxylated hemoglobin polyoxyethylene conjugate,RAF antagonists, raltitrexed, ramosetron, RAS farnesyl proteintransferase inhibitors, RAS inhibitors, RAS-GAP inhibitor, retelliptinedemethylated, rhenium RE 186 etidronate, rhizoxin, riboprine, ribozymes,RII retinamide, RNAi, rogletimide, rohitukine, romurtide, roquinimex,rubiginone B1, ruboxyl, safingol, safingol hydrochloride, saintopin,sarcnu, sarcophytol A, sargramostim, SDI 1 mimetics, semustine,senescence derived inhibitor 1, sense oligonucleotides, signaltransduction inhibitors, signal transduction modulators, simtrazene,single chain antigen binding protein, sizofuran, sobuzoxane, sodiumborocaptate, sodium phenylacetate, solverol, somatomedin bindingprotein, sonermin, sparfosate sodium, sparfosic acid, sparsomycin,spicamycin D, spirogermanium hydrochloride, spiromustine, spiroplatin,splenopentin, spongistatin 1, squalamine, stem cell inhibitor, stem-celldivision inhibitors, stipiamide, streptonigrin, streptozocin,stromelysin inhibitors, sulfinosine, sulofenur, superactive vasoactiveintestinal peptide antagonist, suradista, suramin, swainsonine,synthetic glycosaminoglycans, talisomycin, tallimustine, tamoxifenmethiodide, tauromustine, tazarotene, tecogalan sodium, tegafur,tellurapyrylium, telomerase inhibitors, tcloxantrone hydrochloride,temoporfin, temozolomide, teniposide, teroxirone, testolactone,tetrachlorodecaoxide, tetrazomine, thaliblastine, thalidomide,thiamiprine, thiocoraline, thioguanine, thiotepa, thrombopoietin,thrombopoietin mimetic, thymalfasin, thymopoietin receptor agonist,thymotrinan, thyroid stimulating hormone, tiazofurin, tin ethyletiopurpurin, tirapazamine, titanocene dichloride, topotecanhydrochloride, topsentin, toremifene, toremifene citrate, totipotentstem cell factor, translation inhibitors, trestolone acetate, tretinoin,triacetyluridine, triciribine, triciribine phosphate, trimetrexate,trimetrexate glucuronate, triptorelin, tropisetron, tubulozolehydrochloride, turosteride, tyrosine kinase inhibitors, tyrphostins, UBCinhibitors, ubenimex, uracil mustard, uredepa, urogenital sinus-derivedgrowth inhibitory factor, urokinase receptor antagonists, vapreotide,variolin B, velaresol, veramine, verdins, verteporfin, vinblastinesulfate, vincristine sulfate, vindesine, vindesine sulfate, vinepidinesulfate, vinglycinate sulfate, vinleurosine sulfate, vinorelbine,vinorelbine tartrate, vinrosidine sulfate, vinxaltine, vinzolidinesulfate, vitaxin, vorozole, zanoterone, zeniplatin, zilascorb,zinostatin, zinostatin stimalamer, or zorubicin hydrochloride.

In some embodiments, the therapeutic agents can be part of cocktail ofagents that includes administering two or more therapeutic agents. Forexample, a liposome having both cisplatin and oxaliplatin can beadministered. In addition, the therapeutic agents can be deliveredbefore, after, or with immune stimulatory adjuvants, such as aluminumgel or salt adjuvants (e.g., aluminum phosphate or aluminum hydroxide),calcium phosphate, endotoxins, toll-like receptor adjuvants and thelike.

Therapeutic agents of the present invention can also includeradionuclides for use in therapeutic applications. For example, emittersof Auger electrons, such as ¹¹¹In, can be combined with a chelate, suchas diethylenetriaminepentaacetic acid (DTPA) or1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA), andincluded in a liposome to be used for treatment. Other suitableradionuclide and/or radionuclide-chelate combinations can include butare not limited to beta radionuclides (¹⁷⁷Lu, ¹⁵³Sm, ^(88/90)Y) withDOTA, ⁶⁴Cu-TETA, ^(188/186)Re(CO)₃-IDA; ^(188/186)Re(CO)triamines(cyclic or linear), ^(188/186)Re(CO)₃-Enpy2, and ^(188/186)Re(CO)₃-DTPA.

In some embodiments of the present invention, the therapeutic agent canbe cisplatin, oxaliplatin, carboplatin, gemcitabine, 5-fluorouracil,doxorubicin, and a taxane. In some embodiments, the therapeutic agent iscisplatin or oxaliplatin.

Loading of the therapeutic agents can be carried out through a varietyof ways known in the art, as disclosed for example in the followingreferences: de Villiers, M. M. et al., Eds., Nanotechnology in DrugDelivery, Springer (2009); Gregoriadis, G., Ed., Liposome Technology:Entrapment of drugs and other materials into liposomes, CRC Press(2006). In some embodiments, one or more therapeutic agents can beloaded into liposomes. Loading of liposomes can be carried out, forexample, in an active or passive manner. For example, a therapeuticagent can be included during the self-assembly process of the liposomesin a solution, such that the therapeutic agent is encapsulated withinthe liposome. In certain embodiments, the therapeutic agent may also beembedded in the liposome bilayer or within multiple layers ofmultilamellar liposome. In alternative embodiments, the therapeuticagent can be actively loaded into liposomes. For example, the liposomescan be exposed to conditions, such as electroporation, in which thebilayer membrane is made permeable to a solution containing therapeuticagent thereby allowing for the therapeutic agent to enter into theinternal volume of the liposomes.

Diagnostic Agents

The therapeutic liposomes of the present invention may also containdiagnostic agents. A diagnostic agent used in the present invention caninclude any diagnostic agent known in the art, as provided, for example,in the following references: Armstrong et al., Diagnostic Imaging,5^(th) Ed., Blackwell Publishing (2004); Torchilin, V. P., Ed., TargetedDelivery of Imaging Agents, CRC Press (1995); Vallabhajosula, S.,Molecular Imaging: Radiopharmaceuticals for PET and SPECT, Springer(2009). A diagnostic agent can be detected by a variety of ways,including as an agent providing and/or enhancing a detectable signalthat includes, but is not limited to, gamma-emitting, radioactive,echogenic, optical, fluorescent, absorptive, magnetic or tomographysignals. Techniques for imaging the diagnostic agent can include, butare not limited to, single photon emission computed tomography (SPECT),magnetic resonance imaging (MRI), optical imaging, positron emissiontomography (PET), computed tomography (CT), x-ray imaging, gamma rayimaging, and the like.

In some embodiments, a diagnostic agent can include chelators that bindto metal ions to be used for a variety of diagnostic imaging techniques.Exemplary chelators include but are not limited toethylenediaminetetraacetic acid (EDTA),[4-(1,4,8,11-tetraazacyclotetradec-1-yl) methyl]benzoic acid (CPTA),cyclohexanediaminetetraacetic acid (CDTA),ethylenebis(oxyethylenenitrilo)tetraacetic acid (EGTA),diethylenetriaminepentaacetic acid (DTPA), citric acid, hydroxyethylethylenediamine triacetic acid (HEDTA), iminodiacetic acid (IDA),triethylene tetraamine hexaacetic acid (TTHA),1,4,7,10-tetraazacyclododecane-1,4,7,10-tetra(methylene phosphonic acid)(DOTP), 1,4,8,11-tetraazacyclododecane-1,4,8,11-tetraacetic acid (TETA),1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA), andderivatives thereof.

A radioisotope can be incorporated into some of the diagnostic agentsdescribed herein and can include radionuclides that emit gamma rays,positrons, beta and alpha particles, and X-rays. Suitable radionuclidesinclude but are not limited to ²²⁵Ac, ⁷²As, ²¹¹At, ¹¹B, ¹²⁸Ba, ²¹²Bi,⁷⁵Br, ⁷⁷Br, ¹⁴C, ¹⁰⁹Cd, ⁶²Cu, ⁶⁴Cu, ⁶⁷Cu, ¹⁸F, ⁶⁷Ga, ⁶⁸Ga, ³H, ¹²³I,¹²⁵I, ¹³⁰I, ¹³¹I, ¹¹¹In, ¹⁷⁷Lu, ¹³N, ¹⁵O, ³²P, ³³P, ²¹²Pb, ¹⁰³Pd, ¹⁸⁶Re,¹⁸⁸Re, ⁴⁷Sc, ¹⁵³Sm, ⁸⁹Sr, ^(99m)Tc, ⁸⁸Y and ⁹⁰Y. In certain embodiments,radioactive agents can include ¹¹¹In-DTPA, ^(99m)Tc(CO)₃-DTPA,^(99m)Tc(CO)₃-ENPy2, ^(62/64/67)Cu-TETA, ^(99m)Tc(CO)₃-IDA, and^(99m)Tc(CO)₃triamines (cyclic or linear). In other embodiments, theagents can include DOTA and its various analogs with ¹¹¹In, ¹⁷⁷Lu,¹⁵³Sm, ^(88/90)Y ^(62/64/67)Cu, or ^(67/68)Ga. In some embodiments, theliposomes can be radiolabeled, for example, by incorporation of lipidsattached to chelates, such as DTPA-lipid, as provided in the followingreferences: Phillips et al., Wiley Interdisciplinary Reviews:Nanomedicine and Nanobiotechnology, 1(1): 69-83 (2008); Torchilin, V. P.& Weissig, V., Eds. Liposomes 2nd Ed: Oxford Univ. Press (2003);Elbayoumi, T. A. & Torchilin, V. P., Eur. J. Nucl. Med. Mol. Imaging33:1196-1205 (2006); Mougin-Degraef, M. et al., Int'l J. Pharmaceutics344:110-117 (2007).

In other embodiments, the diagnostic agents can include optical agentssuch as fluorescent agents, phosphorescent agents, chemiluminescentagents, and the like. Numerous agents (e.g., dyes, probes, labels, orindicators) are known in the art and can be used in the presentinvention. (See, e.g., Invitrogen, The Handbook—A Guide to FluorescentProbes and Labeling Technologies, Tenth Edition (2005)). Fluorescentagents can include a variety of organic and/or inorganic small moleculesor a variety of fluorescent proteins and derivatives thereof. Forexample, fluorescent agents can include but are not limited to cyanines,phthalocyanines, porphyrins, indocyanines, rhodamines, phenoxazines,phenylxanthenes, phenothiazines, phenoselenazines, fluoresceins,benzoporphyrins, squaraines, dipyrrolo pyrimidones, tetracenes,quinolines, pyrazines, corrins, croconiums, acridones, phenanthridines,rhodamines, acridines, anthraquinones, chalcogenopyrylium analogues,chlorins, naphthalocyanines, methine dyes, indoleniurn dyes, azocompounds, azulenes, azaazulenes, triphenyl methane dyes, indoles,benzoindoles, indocarbocyanines, benzoindocarbocyanines, and BODIPY™derivatives having the general structure of4,4-difluoro-4-bora-3a,4a-diaza-s-indacene, and/or conjugates and/orderivatives of any of these. Other agents that can be used include, butare not limited to, for example, fluorescein, fluorescein-polyasparticacid conjugates, fluorescein-polyglutamic acid conjugates,fluorescein-polyarginine conjugates, indocyanine green,indocyanine-dodecaaspartic acid conjugates, indocyanine-polyasparticacid conjugates, isosulfan blue, indole disulfonates, benzoindoledisulfonate, bis(ethylcarboxymethyl)indocyanine,bis(pentylcarboxymethyl)indocyanine, polyhydroxyindole sulfonates,polyhydroxybenzoindole sulfonate, rigid heteroatomic indole sulfonate,indocyaninebispropanoic acid, indocyaninebishexanoic acid,3,6-dicyano-2,5-[(N,N,N′,N′-tetrakis(carboxymethyl)amino]pyrazine,3,6-[(N,N,N′,N′-tetrakis(2-hydroxyethyl)amino]pyrazine-2,5-dicarboxylicacid, 3,6-bis(N-azatedino)pyrazine-2,5-dicarboxylic acid,3,6-bis(N-morpholino)pyrazine-2,5-dicarboxylic acid,3,6-bis(N-piperazino)pyrazine-2,5-dicarboxylic acid,3,6-bis(N-thiomorpholino)pyrazine-2,5-dicarboxylic acid,3,6-bis(N-thiomorpholino)pyrazine-2,5-dicarboxylic acid S-oxide,2,5-dicyano-3,6-bis(N-thiomorpholino)pyrazine S,S-dioxide,indocarbocyaninetetrasulfonate, chloroindocarbocyanine, and3,6-diaminopyrazine-2,5-dicarboxylic acid.

One of ordinary skill in the art will appreciate that particular opticalagents used can depend on the wavelength used for excitation, depthunderneath skin tissue, and other factors generally well known in theart. For example, optimal absorption or excitation maxima for theoptical agents can vary depending on the agent employed, but in general,the optical agents of the present invention will absorb or be excited bylight in the ultraviolet (UV), visible, or infrared (IR) range of theelectromagnetic spectrum. For imaging, dyes that absorb and emit in thenear-IR (˜700-900 nm, e.g., indocyanines) are preferred. For topicalvisualization using an endoscopic method, any dyes absorbing in thevisible range are suitable.

In some embodiments, the non-ionizing radiation employed in the processof the present invention can range in wavelength from about 350 nm toabout 1200 nm. In one exemplary embodiment, the fluorescent agent can beexcited by light having a wavelength in the blue range of the visibleportion of the electromagnetic spectrum (from about 430 nm to about 500nm) and emits at a wavelength in the green range of the visible portionof the electromagnetic spectrum (from about 520 nm to about 565 nm). Forexample, fluorescein dyes can be excited with light with a wavelength ofabout 488 nm and have an emission wavelength of about 520 nm. As anotherexample, 3,6-diaminopyrazine-2,5-dicarboxylic acid can be excited withlight having a wavelength of about 470 nm and fluoresces at a wavelengthof about 532 nm. In another embodiment, the excitation and emissionwavelengths of the optical agent may fall in the near-infrared range ofthe electromagnetic spectrum. For example, indocyanine dyes, such asindocyanine green, can be excited with light with a wavelength of about780 nm and have an emission wavelength of about 830 nm.

In yet other embodiments, the diagnostic agents can include but are notlimited to magnetic resonance (MR) and x-ray contrast agents that aregenerally well known in the art, including, for example, iodine-basedx-ray contrast agents, superparamagnetic iron oxide (SPIO), complexes ofgadolinium or manganese, and the like. (See, e.g., Armstrong et al.,Diagnostic Imaging, 5^(th) Ed., Blackwell Publishing (2004)). In someembodiments, a diagnostic agent can include a magnetic resonance (MR)imaging agent. Exemplary magnetic resonance agents include but are notlimited to paramagnetic agents, superparamagnetic agents, and the like.Exemplary paramagnetic agents can include but are not limited togadopentetic acid, gadoteric acid, gadodiamide, gadolinium, gadoteridolmangafodipir, gadoversetamide, ferric ammonium citrate, gadobenic acid,gadobutrol, or gadoxetic acid. Superparamagnetic agents can include butare not limited to superparamagnetic iron oxide and ferristene. Incertain embodiments, the diagnostic agents can include x-ray contrastagents as provided, for example, in the following references: H. SThomsen, R. N. Muller and R. F. Mattrey, Eds., Trends in Contrast Media,(Berlin: Springer-Verlag, 1999); P. Dawson, D. Cosgrove and R. Grainger,Eds., Textbook of Contrast Media (ISIS Medical Media 1999); Torchilin,V. P., Curr. Pharm. Biotech. 1:183-215 (2000); Bogdanov, A. A. et al.,Adv. Drug Del. Rev. 37:279-293 (1999); Sachse, A. et al., InvestigativeRadiology 32(1):44-50 (1997). Examples of x-ray contrast agents include,without limitation, iopamidol, iomeprol, iohexol, iopentol, iopromide,iosimide, ioversol, iotrolan, iotasul, iodixanol, iodecimol,ioglucamide, ioglunide, iogulamide, iosarcol, ioxilan, iopamiron,metrizamide, iobitridol and iosimenol. In certain embodiments, the x-raycontrast agents can include iopamidol, iomeprol, iopromide, iohexol,iopentol, ioversol, iobitridol, iodixanol, iotrolan and iosimenol.

As for the therapeutic agents described above, the diagnostic agents canbe associated with the therapeutic liposome in a variety of ways,including for example being embedded or encapsulated in the liposome.Similarly, loading of the diagnostic agents can be carried out through avariety of ways known in the art, as disclosed for example in thefollowing references: de Villiers, M. M. et al., Eds., Nanotechnology inDrug Delivery, Springer (2009); Gregoriadis, G., Ed., LiposomeTechnology: Entrapment of drugs and other materials into liposomes, CRCPress (2006).

Formulation and Administration

In some embodiments, the present invention can include a liposomecomposition and a physiologically (i.e., pharmaceutically) acceptablecarrier. As used herein, the term “carrier” refers to a typically inertsubstance used as a diluent or vehicle for a drug such as a therapeuticagent. The term also encompasses a typically inert substance thatimparts cohesive qualities to the composition. Typically, thephysiologically acceptable carriers are present in liquid form. Examplesof liquid carriers include physiological saline, phosphate buffer,normal buffered saline (135-150 mM NaCl), water, buffered water, 0.4%saline, 0.3% glycine, glycoproteins to provide enhanced stability (e.g.,albumin, lipoprotein, globulin, etc.), and the like. Sincephysiologically acceptable carriers are determined in part by theparticular composition being administered as well as by the particularmethod used to administer the composition, there are a wide variety ofsuitable formulations of pharmaceutical compositions of the presentinvention (See, e.g., Remington's Pharmaceutical Sciences, 17^(th) ed.,1989).

The compositions of the present invention may be sterilized byconventional, well-known sterilization techniques or may be producedunder sterile conditions. Aqueous solutions can be packaged for use orfiltered under aseptic conditions and lyophilized, the lyophilizedpreparation being combined with a sterile aqueous solution prior toadministration. The compositions can contain pharmaceutically acceptableauxiliary substances as required to approximate physiologicalconditions, such as pH adjusting and buffering agents, tonicityadjusting agents, wetting agents, and the like, e.g., sodium acetate,sodium lactate, sodium chloride, potassium chloride, calcium chloride,sorbitan monolaurate, and triethanolamine oleate. Sugars can also beincluded for stabilizing the compositions, such as a stabilizer forlyophilized liposome compositions.

The liposome composition of choice, alone or in combination with othersuitable components, can be made into aerosol formulations (i.e., theycan be “nebulized”) to be administered via inhalation. Aerosolformulations can be placed into pressurized acceptable propellants, suchas dichlorodifluoromethane, propane, nitrogen, and the like.

Suitable formulations for rectal administration include, for example,suppositories, which includes an effective amount of a packaged liposomecomposition with a suppository base. Suitable suppository bases includenatural or synthetic triglycerides or paraffin hydrocarbons. Inaddition, it is also possible to use gelatin rectal capsules whichcontain a combination of the liposome composition of choice with a base,including, for example, liquid triglycerides, polyethylene glycols, andparaffin hydrocarbons.

Formulations suitable for parenteral administration, such as, forexample, by intraarticular (in the joints), intravenous, intramuscular,intratumoral, intradermal, intraperitoneal, and subcutaneous routes,include aqueous and non-aqueous, isotonic sterile injection solutions,which can contain antioxidants, buffers, bacteriostats, and solutes thatrender the formulation isotonic with the blood of the intendedrecipient, and aqueous and non-aqueous sterile suspensions that caninclude suspending agents, solubilizers, thickening agents, stabilizers,and preservatives. Injection solutions and suspensions can also beprepared from sterile powders, granules, and tablets. In the practice ofthe present invention, compositions can be administered, for example, byintravenous infusion, topically, intraperitoneally, intravesically, orintrathecally. Parenteral administration and intravenous administrationare the preferred methods of administration. The formulations ofliposome compositions can be presented in unit-dose or multi-dose sealedcontainers, such as ampoules and vials.

The pharmaceutical preparation is preferably in unit dosage form. Insuch form the preparation is subdivided into unit doses containingappropriate quantities of the active component, e.g., a liposomecomposition. The unit dosage form can be a packaged preparation, thepackage containing discrete quantities of preparation. The compositioncan, if desired, also contain other compatible therapeutic agents.

In therapeutic use for the treatment of cancer, the liposomecompositions including a therapeutic and/or diagnostic agent utilized inthe pharmaceutical compositions of the present invention can beadministered at the initial dosage of about 0.001 mg/kg to about 1000mg/kg daily. A daily dose range of about 0.01 mg/kg to about 500 mg/kg,or about 0.1 mg/kg to about 200 mg/kg, or about 1 mg/kg to about 100mg/kg, or about 10 mg/kg to about 50 mg/kg, can be used. The dosages,however, may be varied depending upon the requirements of the patient,the severity of the condition being treated, and the liposomecomposition being employed. For example, dosages can be empiricallydetermined considering the type and stage of cancer diagnosed in aparticular patient. The dose administered to a patient, in the contextof the present invention, should be sufficient to affect a beneficialtherapeutic response in the patient over time. The size of the dose willalso be determined by the existence, nature, and extent of any adverseside-effects that accompany the administration of a particular liposomecomposition in a particular patient. Determination of the proper dosagefor a particular situation is within the skill of the practitioner.Generally, treatment is initiated with smaller dosages which are lessthan the optimum dose of the liposome composition. Thereafter, thedosage is increased by small increments until the optimum effect undercircumstances is reached. For convenience, the total daily dosage may bedivided and administered in portions during the day, if desired.

Targeting Agents

In some cases, liposome accumulation at a target site may be due to theenhanced permeability and retention characteristics of certain tissuessuch as cancer tissues. Accumulation in such a manner often results inpart because of liposome size and may not require special targetingfunctionality. In other cases, the liposomes of the present inventioncan also include a targeting agent. Generally, the targeting agents ofthe present invention can associate with any target of interest, such asa target associated with an organ, tissues, cell, extracellular matrix,or intracellular region. In certain embodiments, a target can beassociated with a particular disease state, such as a cancerouscondition. In some embodiments, the targeting component can be specificto only one target, such as a receptor. Suitable targets can include butare not limited to a nucleic acid, such as a DNA, RNA, or modifiedderivatives thereof. Suitable targets can also include but are notlimited to a protein, such as an extracellular protein, a receptor, acell surface receptor, a tumor-marker, a transmembrane protein, anenzyme, or an antibody. Suitable targets can include a carbohydrate,such as a monosaccharide, disaccharide, or polysaccharide that can be,for example, present on the surface of a cell.

In certain embodiments, a targeting agent can include a target ligand(e.g., an RGD-containing peptide), a small molecule mimic of a targetligand (e.g., a peptide mimetic ligand), or an antibody or antibodyfragment specific for a particular target. In some embodiments, atargeting agent can further include folic acid derivatives, B-12derivatives, integrin RGD peptides, NGR derivatives, somatostatinderivatives or peptides that bind to the somatostatin receptor, e.g.,octreotide and octreotate, and the like. The targeting agents of thepresent invention can also include an aptamer. Aptamers can be designedto associate with or bind to a target of interest. Aptamers can becomprised of, for example, DNA, RNA, and/or peptides, and certainaspects of aptamers are well known in the art. (See. e.g., Klussman, S.,Ed., The Aptamer Handbook, Wiley-VCH (2006); Nissenbaum, E. T., Trendsin Biotech. 26(8): 442-449 (2008)).

Kits for Administration of Active Agents

In another aspect, the present invention also provides kits foradministering the liposomes and lipid nanoparticles to a subject fortreating a disease state. In some embodiments, the invention provides akit for delivering a therapeutic agent to a subject, the kit comprising:a) a first composition comprising a liposome containing a therapeuticagent; and b) a second composition comprising a lipid nanoparticlecontaining a non-ionic triggering agent; wherein the first and secondcompositions are stored separately prior to administration to thesubject.

Such kits typically include two or more components necessary fortreating a disease state, such as a cancerous condition. Components caninclude the lipid compositions of the present invention, reagents,buffers, containers and/or equipment. The liposomes and lipidnanoparticles can be in lyophilized form and then reconstituted prior toadministration. In certain embodiments, the kits of the presentinvention can include packaging assemblies that can include one or morecomponents used for treating the disease state of a patient. Forexample, a packaging assembly may include separate containers that housethe therapeutic liposomes and attacking agents as described herein. Aseparate container may include other excipients or agents that can bemixed with the compositions prior to administration to a patient. Insome embodiments, a physician may select and match certain componentsand/or packaging assemblies depending on the treatment or diagnosisneeded for a particular patient.

IV. Examples

The practice of this invention is illustrated with, but not intended tobe limited by, the examples in Table A. Through these examples, it isclearly demonstrated in vitro that the attacking liposome can be used totrigger the release of cargo from therapeutic liposomes with otherwisepoor release characteristics. In examples 1, 2 and 11-12, thetherapeutic liposomes contain cytotoxic agents including cisplatin oroxaliplatin. In Examples 3-10, 5-carboxyfluorescein (5-CF) is used as amarker in therapeutic liposome compositions. The characteristics ofthese samples are summarized in Table A below. Examples 1-5 and 10 showthat the same attacking liposome (Part B) is used for triggering and/orenhancing the release of a variety of therapeutic liposome compositions(Part A) with or without stealth functionality. Examples 6-9 show thecritical role of the triggering agent in the attacking liposome. Thesurface charge of the attacking liposome is essentially neutral inExamples 8 and 9.

TABLE A Examples of Therapeutic and Attacking Liposomes EncapsulatedTherapeutic Liposome Attacking Liposome Example Cargo Part A Part B 1Oxaliplatin NLI COV003 F-02 - Non-stealth 4460-075 - charged(+)/TPGSDSPC/DSPG/Chol DPPC/Chol/TPGS/DOTAP (70/20/10) (42/10/32/16) 2 CisplatinNLI COV00AR-02 - Non-stealth 4460-075 - charged(+)/TPGS DSPC/DSPG/Chol(70/20/10) 3 5-CF 4460-090 - Non-stealth 4460-075 - charged(+)/TPGSDSPC/DSPG/Chol (48/12/40) 4 5-CF 4460-077 - Non-stealth 4460-075 -charged(+)/TPGS DSPC/DSPG/Chol (70/20/10) 5 5-CF 4386-143 - Stealth4460-075 - charged(+)/TPGS DSPC/Chol/DSPE-PEG(2000) (55/40/5) 6 5-CF4460-090 - Non-stealth 4460-084 - charged (+) DPPC/Chol/DOTAP (73/11/16)7 5-CF 4460-077 - Non-stealth 4460-084 - charged (+) 8 5-CF 4460-090 -Non-stealth 4384-086 - charge(0)/TPGS DPPC/Chol/TPGS (60/10/30) 9 5-CF4460-077 - Non-stealth 4384-086 - charge(0)/TPGS 10 5-CF 4460-090 -Non-stealth 4460-075 - charged(+)/TPGS 11 Oxaliplatin NH COV003F-02 -Non-stealth 4460-104 - charged(+)/TPGS DPPC/Chol/TPGS/DOTAP(42/10/32/16) 12 Cisplatin NLI 4481101 - Stealth 4460-104 -charged(+)/TPGS HSPC/Chol/DSPE-PEG(2000) (55/40/5)

Example 1

The compositions of a therapeutic liposome (NLICOV003F-02) containingoxaliplatin and an attacking liposome (4460-075 DPPC/Chol/DOTAP/TPGS)are shown in Table 1. The therapeutic liposome (Northern Lipid Inc.)contained 2.9 mg/mL of oxaliplatin and 71.8 mg/mL of total lipids. Theattacking liposome was prepared by the following steps:

-   -   1. All lipids were weighed and placed in a round bottom flask.    -   2. 3:1 (v/v) chloroform/methanol was added to the flask to        dissolve all lipids; the lipid concentration was about 2.5 wt %.    -   3. Solvents were removed from the lipid mixture using a        rotoevaporator at 40° C., and vacuum was applied via the        rotoevaporator for 0.5 hrs at 40° C. to remove residual        solvents.    -   4. Drying was continued under house vacuum overnight at room        temperature to remove the trace solvents.    -   5. Phosphate buffer saline (PBS) 1× solution (0.0067 M) was        added to the dried lipid film around the bottom of the flask,        and the dispersion was agitated at 70° C. for one hour.    -   6. The lipid dispersion (multi-lamellar vesicle dispersion) was        extruded 5 times through a double packed 200 nm polycarbonate        film at 70° C. in a 10-mL extruder under a pressure of ˜200 psi.    -   7. Extrusion was continued 10 times through a double packed 100        nm polycarbonate film at 70° C. under a pressure of ˜300 psi.    -   8. The extruded liposome sample was collected and particle size        and zeta potential were measured using a Malvern Zetasizer Nano        ZS.

The release of oxaliplatin in vitro from NLICOV003F-02 was conducted inPBS 1× (pH=7.4 and 5.0) solutions by admixing an aliquot of attackingliposome with the therapeutic liposome. The first sample was immediatelycollected (within less than 3 min) at room temperature and prepared formeasuring the oxaliplatin release. The release was determined byfiltering the samples through Amicon 50K MWCO centrifugal filters at16500 rpm for 5 minutes. The released oxaliplatin in the liposome-freeaqueous phase was analyzed by ICP-OES. After taking the immediatesample, the mixture was subsequently incubated at 37° C. for 48 hours.Samples were collected subsequently at 1, 6, 24 and 48 hours foranalysis of oxaliplatin release. The results are shown in Table 1 and 2.The data shown in Table 2 and plotted in FIG. 1 indicate the totalrelease of therapeutic liposome (NLICOV003F-02) was increased from ˜5%at time zero to ˜40% in 6-hrs by the addition of an equal amount ofattacking liposome (4460-075). The results also indicate that the totalrelease of therapeutic liposome contents increases with the amount ofattacking liposome at both pH conditions. The therapeutic liposome is anon-stealth charged liposome containing 10 mol % cholesterol. Theattacking liposome is oppositely charged and contains 32 mol % TPGS.

TABLE 1 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic NLI DSPC/DSPG/Chol= 83.6 −22.6 liposome COV003F- 70/20/10 02 Attacking 4460-075 DPPC/Chol/80.3 11.4 liposome TPGS/DOTAP = 42/10/32/16

TABLE 2 In-vitro release of Dualsome in PBS 1X (pH = 7.4 and pH = 5.01)Therapeutic Attacking Liposome Liposome Immediate (NLICOV003F-02)(4460-075) Encapsulated Release after Release Release Release ReleaseAmount (mL) Amount (mL) Therapeutics mixing at 1 hour at 6 hour at 24hour at 48 hour PBS 1X (01 = 7.4) Added (mL) 0.5 0.0 4.5 Oxaliplatin3.74% 4.17% 4.32% 4.58% 4.53% 0.5 0.1 4.4 Oxaliplatin 14.76% 26.17%28.46% 32.52% 21.38% 0.5 0.2 4.3 Oxaliplatin 18.61% 33.07% 36.55% 26.48%22.33% 0.5 0.5 4.0 Oxaliplatin 24.69% 42.65% 43.21% 29.22% 24.33% PBS IX(pH = 5.0) Added (mL) 0.5 0.0 4.5 Oxaliplatin 3.90% 4.37% 4.54% 4.82%5.14% 0.5 0.1 4.4 Oxaliplatin 15.46% 26.44% 28.95% 28.86% 21.47% 0.5 0.24.3 Oxaliplatin 21.11% 34.39% 37.16% 28.30% 24.74% 0.5 0.5 4.0Oxaliplatin 26.06% 41.75% 45.62% 30.94% 28.13%

Example 2

This example illustrates the enhanced cisplatin from therapeuticliposomes upon addition of different amounts of the attacking liposome.Therapeutic liposomes containing 2.5 mg/mL of cisplatin and 77.5 mg/mLof total lipids (NLICOV00AR-02, Northern Lipids Inc.) were prepared viaa passive loading procedure. The attacking liposome consisting of DPPC,cholesterol, DOTAP, and TPGS (4460-075) was prepared as described inExample 1.

The in vitro cisplatin release from NLICOV00AR-02 was conducted in PBS1× (pH=7.4 and 5.0) solutions by adding aliquots of attacking liposome(4460-075) to the therapeutic liposome. Samples were collectedimmediately at room temperature, and at 1, 6, 24 and 48 hours afterincubation at 37° C. The samples were filtered through Amicon 50K MWCOcentrifugal filters at 16500 rpm for 5 minutes. The cisplatin releasedin the liposome-free aqueous phase was analyzed by ICP-OES. The resultsare shown in Table 3 and 4. The data shown in Table 4 were plotted andshown in FIG. 2. The results indicate that the total release oftherapeutic liposome (NLICOV00AR-02) at 48 hr was increased from ˜1%without attacking liposome to ˜27% with an equal amount of attackingliposome. The results also indicate that the total release oftherapeutic liposome increased as the amount of attacking liposomeincreased at both pH conditions. In this example, the therapeuticliposome was a non-stealth, charged liposome containing 10 mol %cholesterol. The attacking liposome was oppositely charged and contained32 mol % TPGS.

TABLE 3 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic NLI DSPC/DSPG/Chol= 96.3 −22.4 liposome COV00AR- 70/20/10 02 Attacking 4460-075 DPPC/Chol/80.3 11.4 liposome TPGS/DOTAP = 42/10/32/16

TABLE 4 In-vitro release of Dualsome in PBS 1X (pH = 7.4 and pH = 5.0)Attacking Therapeutic Liposome Liposome (4460-075) Immediate(NLICOV00AR-02) Amount Encapsulated Release after Release ReleaseRelease Release Amount (mL) (mL) Therapeutics mixing at 1 hour at 6 hourat 24 hour at 48 hour PBS IX (pH = 7.4) Added (mL) 0.5 0.0 4.5 Cisplatin0.97% 1.05% L05% 1.13% 1.11% 0.5 0.1 4.4 Cisplatin 4.90% 7.84% 9.25%10.65% 11.88% 0.5 0.2 4.3 Cisplatin 5.68% 10.63% 12.47%  15.45% 17.55%0.5 0.5 4.0 Cisplatin 7.20% 14.60% 17.62%  21.84% 26.73% PBS 5X (01 =5.0) Added (mL) 0.5 0.0 4.5 Cisplatin 1.01% 1.02% 1.05% 1.16% 1.20% 0.50.1 4.4 Cisplatin 5.65% 7.88% 9.25% 11.66% 13.96%

Example 3

In this example, the attacking liposome (Part B, 4460-075) consisted ofDPPC, cholesterol, DOTAP, and TPGS as given in Table 5; the method ofpreparation was the same as described in Example 1. The therapeuticliposome (Part A, 4460-090) contained 5-carboxyfluorescein (5-CF) as amarker. The liposome containing 5-CF was made by the passive loadingprocedure as described below:

-   -   1. Lipid components were weighed and placed in a round bottom        flask.    -   2. 3:1 (v/v) chloroform/methanol was added to dissolve all        lipids; the concentration was about 2.5 wt %.    -   3. Solvents were removed from the lipid mixture using a        rotoevaporator at 40° C., and vacuum was applied via the        rotoevaporator for 0.5 hrs at 40° C. to remove residual        solvents.    -   4. Drying was continued using the house vacuum overnight at room        temperature to remove trace solvents.    -   5. Phosphate buffer saline (PBS) 1× solution (0.0067 M) was        added to the dried lipid film around the bottom of the flask,        and the resulting dispersion was agitated at 70° C. for one        hour. In this step, 5-carboxyfluorescein (5-CF) was added to PBS        at a concentration of 2.0 mg/mL. The pH value of the dispersion        was adjusted to 7.10    -   6. The lipid vesicle dispersion was extruded 5 times through a        double packed 200 nm polycarbonate film at 70° C. with a 10-mL        extruder under a pressure of ˜200 psi.    -   7. The extrusion was continued 10 times through a double packed        100 nm polycarbonate film at 70° C. under a pressure of ˜300        psi.    -   8. The final liposome preparation was injected into a 3.0-12.0        mL 20,000 MWCO cassette for dialysis.    -   9. The liposome preparation was dialyzed against 1000 mL PBS 1×        solution for 24 hours.    -   10. Dialysis was repeated two additional times with 1000 mL        fresh PBS 1× buffer.    -   11. The dialyzed liposomes were collected, and particle size and        zeta potential were measured using a Malvern Zetasizer Nano ZS.

Liposome Part A was mixed with Part B and the release of 5-CF to theliposome-free aqueous phase was determined by an Agilent 1200 HPLC witha Waters 2475 Multi-Wavelength Fluorescence Detector (S/N 608975406M).The column was a BDS Hypersil C18 column (150 mm×3.0 μm, ThermoScientific, S/N: 0908389T, Lot #10770). The mobile phase consisted of 5%(wt) IPA/5% (wt) ACN/90% (wt) water with 50 mM Ammonium acetate. Nogradient was applied. The flow rate was 0.8 mL/min at 40° C. Theinjection volume was 5.0 μL. The run time was set to 5 minutes, and theCF-5 eluted at ˜1.0 min. For fluorescence detection, an excitationwavelength of 492 nm and an emission wavelength of 514 nm were used. TheEUFS was set to 50,000 and the gain was set to 1.0 on the detector.External standards of CF-5 in PBS 1× were used for calibration. Thelinear calibration range was from 0.05 μg/mL to 2.0 μg/mL, resulting inan R² value greater than 0.99.

The results shown in Table 6 and plotted in FIG. 3 indicate the totalrelease of therapeutic liposome (4460-090) at 48-hours increased from˜4% to ˜16% by the addition of an equal amount of attacking liposome(4460-075) in PBS 1× at pH 7.4. The results also suggest the release oftherapeutic liposome increased with the increasing initial amount ofattacking liposome. In this example, liposome Part A was a non-stealthcharged liposome containing 40 mol % cholesterol. The attackingliposome, Part B, was oppositely charged and contained TPGS.

TABLE 5 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic 4460-090DSPC/DSPG/Chol = 109.2 −17.4 liposome 48/12/40 Attacking 4460-075DPPC/Cho1/ 80.3 11.4 liposome TPGS/DOTAP = 42/10/32/16

TABLE 6 In-vitro release of Dualsome in PBS 1X (pH = 7.4) TherapeuticAttacking Liposome Liposome PBS 1X (4460-090) (4460-075) (pH = 7.4)Immediate Amount Amount Added Encapsulated Release after Release ReleaseRelease Release (mL) (mL) (mL) Therapeutics mixing at 1 hour at 6 hourat 24 hour at 48 hour 0.5 0.0 9.5 5-CF 0.60% 0.85% 1.50% 2.98% 4.07% 0.50.1 9.4 5-CF 5.78% 5.87% 7.23% 8.92% 8.08% 0.5 0.5 4.0 5-CF 8.25% 15.56%18.04% 17.66% 16.33%

Example 4

In this example, therapeutic liposome Part A (4460-077) contained 5-CF(5-carboxyfluorescein) as the marker, and the lipid composition was thesame as the therapeutic liposome composition in Examples 1 and 2. Thecomposition of the attacking liposome, Part B, was the same as inExamples 1 and 2 (see Table 7).

The results shown in Table 8 and plotted in FIG. 4 indicate that thetotal release of 5-CF from liposome Part A (4460-077) at 48 hoursincreased from ˜5% to ˜32% by the addition of an equal amount ofattacking liposome Part B (4460-075) in PBS 1× at pH 7.4. The resultsalso show that the release of 5-CF from liposome Part A increased as theinitial amount of liposome Part B increased. These results areconsistent with the finding as described in Example 1 and 2. In thisexample, liposome Part A was a non-stealth, charged liposome containing10 mol % cholesterol. The attacking liposome Part B was oppositelycharged and contained TPGS.

TABLE 7 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic 4460-077DSPC/DSPG/Chol = 88.1 −20.5 liposome 70/20/10 Attacking 4460-075DPPC/Chol/ 80.3 11.4 liposome TPGS/DOTAP = 42/10/32/16

TABLE 8 In-vitro release of Dualsome in PBS 1X (pH = 7.4) AttackingTherapeutic Liposome PBS IX Liposome (4460-077) (4460.075) (pH = 7.4)Immediate Amount Amount Added Encapsulated Release after Release ReleaseRelease Release (mL) (mL) (mL) Therapeutics mixing at 1 hour at 6 hourat 24 hour at 48 hour 0.5 0.0 9.5 5-CF 2.69% 3.04% 3.42% 4.25% 5.34% 0.50.1 9.4 5-CF 16.58% 24.75% 26.48% 30.84% 29.36% 0.5 0.5 4.0 5-CF 13.08%24.96% 26.08% 30.36% 32.48%

Example 5

In this example, liposome Part A (4386-143) was loaded with5-carboxyfluorescein (5-CF) in the interior aqueous phase as in Examples3 and 4. The compositions of liposome Part A and B (4460-075) are givenTable 9.

The results shown in Table 10 and plotted in FIG. 5 indicate that thetotal release of 5-CF from liposome Part A (4386-143) at 48 hoursincreased from ˜2% to ˜20% by the addition of an equal amount ofattacking liposome Part B (4460-075) in PBS 1× at pH 7.4. The resultsalso show the release of liposome Part A increased as the initial amountof attacking liposome Part B increased. In this example, the therapeuticliposome was a stealth liposome containing 40 mol % cholesterol. Theattacking liposome was oppositely charged and contained TPGS.

TABLE 9 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic 4386-143 DSPC/Chol/91.1 −0.87 liposome DSPE-PEG(2000) = 55/40/5 Attacking 4460-075DPPC/Chol/ 80.3 11.4 liposome TPGS/DOTAP = 42/10/32/16

TABLE 10 In-vitro release of Dualsome in PBS 1X (pH = 7.4) TherapeuticAttacking Liposome Liposome PBS 1X (4386-143) (4460-075) (pH = 7.4)Immediate Immediate Amount Amount Added Release after Release ReleaseRelease Release Release after (mL) (mL) (mL) mixing at 1 hour at 6 hourat 24 hour at 48 hour mixing 0.5 0.0 9.5 5-CE 0.92% 1.10% 1.07% 1.58%2.04% 0.5 0.1 9.4 5-CF 5.40% 8.32% 10.26% 13.52% 13.25% 0.5 0.5 4.0 5-CF9.50% 12.82% 18.30% 20.80% 19.72%

Example 6

In this example, the compositions of liposome Part A and B are shown inTable 11. The therapeutic liposome Part A (4460-090) contained 5-CF. Itshould be noted that the attacking liposome, Part B (4460-084), did notinclude triggering agent TPGS in the composition. The results shown inTable 12 and plotted in FIG. 6 indicate that the total release ofliposome Part A (4460-090) was not affected by the addition of attackingliposome Part B (4460-084) in PBS 1× at pH 7.4. In this example, thetherapeutic liposome was a non-stealth liposome containing 40 mol %cholesterol. The attacking liposome was oppositely charged but did notinclude TPGS.

This example clearly illustrates the necessity of a triggering agentlike TPGS in the attacking liposome composition in order to trigger therelease of liposome Part A. Without TPGS, essentially, there was noenhanced release observed as shown in this example.

TABLE 11 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic 4460-090DSPC/DSPG/Chol = 109.2 −17.4 liposome 48/12/40 Attacking 4460-084DPPC/Chol/ 91.56 23.0 liposome DOTAP = 73/11/16

TABLE 12 In-vitro release of Dualsome in PBS 1X (pH = 7.4) TherapeuticAttacking Liposome Liposome PBS IX (4460-090) (4460-084) (pH = 7.4)Immediate Amount Amount Added Encapsulated Release after Release ReleaseRelease Release (mL) (mL) (mL) Therapeutics mixing at 1 hour at 6 hourat 24 hour at 48 hour 0.5 0.0 9.5 5-CF 0.60% 0.85% 1.50% 2.98% 4.07% 0.50.1 9.4 5-CF 0.60% 1.51% 2.08% 3.34% 4.67% 0.5 0.5 4.0 5-CF 0.83% 1.60%2.45% 9.45% 4.19%

Example 7

In this example, the compositions of liposome Part A and B are shown inTable 13. The therapeutic liposome Part A (4460-077) contained 5-CF. Itshould be noted that the attacking liposome, Part B (4460-084), did notcontain triggering agent TPGS in the composition. The results shown inTable 14 and plotted in FIG. 7 indicate the total release of liposomePart A (4460-077) was not affected by the addition of attacking liposomePart B (4460-084) in PBS 1× at pH 7.4. In this example, the therapeuticliposome was a non-stealth liposome containing 10 mol % cholesterol. Theattacking liposome was oppositely charged but without TPGS. Without TPGSin Part B, there was no enhanced release observed for Part A as shown inthis example.

TABLE 13 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic 4460-077DSPC/DSPG/Chol = 88.1 −20.5 liposome 70/20/10 Attacking 4460-084DPPC/Chol/ 91.56 23.0 liposome DOTAP = 73/11/16

TABLE 14 In-vitro release of Dualsome in PBS 1X (pH = 7.4) AttackingTherapeutic Liposome PBS 1X Liposome (4460-084) (pH = 7.4) Immediate(4460-077) Amount Added Encapsulated Release after Release ReleaseRelease Release Amount (mL) (mL) (mL) Therapeutics mixing at 1 hour at 6hour at 24 hour at 48 hour 0.5 0.0 9.5 5-CF 2.69% 3.04% 3.42% 4.25%5.34% 0.5 01 9.4 5-CF 2.23% 2.86% 3.18% 4.53% 5.47% 0.5 0.5 4.0 5-CF1.94% 2.51% 3.04% 4.99% 6.34%

Example 8

In this example, the compositions liposome Part A and B are shown inTable 15. The therapeutic liposome Part A (4460-090) contained 5-CFwhich is the same as in Example 6. The attacking liposome (4384-086) didnot contain positively charged lipid DOTAP, but contained 30 mol % TPGS.The results shown in Table 16 and plotted in FIG. 8 indicate that thetotal release of 5-CF at 48-hours from liposome Part A (4460-090) in PBS1× at pH 7.4 increased from ˜4% to ˜20% by the addition of an equalamount of attacking liposome. The results also indicate 5-CF releasefrom therapeutic liposome increased with the increasing initial amountof the attacking liposome. The therapeutic liposome was a stealthliposome containing 40 mol % cholesterol level.

TABLE 15 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic 4460-090DSPC/DSPG/Chol = 109.2 −17.4 liposome 48/12/40 Attacking 4384-086DPPC/Chol/TPGS = 92.67 5.51 liposome 60/10/30

TABLE 16 In-vitro release of Dualsome in PBS 1X (pH-7.4) TherapeuticAttacking Liposome Liposome PBS 1X (4460-090) (4384-086) (pH = 7.4)Immediate Amount Amount Added Encapsulated Release after Release ReleaseRelease Release (mL) (mL) (mL) Therapeutics mixing at 1 hour at 6 hourat 24 hour at 48 hour 0.5 0.0 9.5 5-CF 0.60% 0.85% 1.50% 2.98% 4.07% 0.50.1 9.4 5-CF 6.77% 7.53% 8.07% 8.99% 9.34% 0.5 0.5 4.0 5-CF 15.44%16.20% 18.87% 19.64% 19.74%

Example 9

In this example, the compositions of liposome Part A and B are shown inTable 17. The therapeutic liposome Part A (4460-077) contained 5-CFwhich is the same as in Example 4. The therapeutic liposome was astealth liposome containing 10 mol % cholesterol. The attacking liposomePart B (4460-086) contained 30 mole % TPGS in the composition and nocharged lipid DOTAP, as in Example 5. The results shown in Table 18 andplotted in FIG. 9 indicate that the total release of 5-CF at 48 hoursfrom liposome (4460-077) increased from ˜5% to ˜34% by the addition ofan equal amount of attacking liposome (4384-086) in PBS 1× at pH 7.4.The results also indicate that 5-CF release from liposome (4460-077)increased with the increasing initial amount of attacking liposome.

TABLE 17 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic 4460-077DSPC/DSPG/Chol = 88.1 −20.5 liposome 70/20/10 Attacking 4384-086DPPC/Chol/ 92.67 5.51 liposome TPGS = 60/10/30

TABLE 18 In-vitro release of Dualsome in PBS 1X (pH = 7.4) ThempeuticAttacking Liposome Liposome PBS 1X (4460-077) (4384-086) (pH = 7.4)Immediate Amount Amount Added Encapsulated Release after Release ReleaseRelease Release (mL) (mL) (mL) Therapeutics mixing at 1 hour at 6 hourat 24 hour at 48 hour 0.5 0.0 9.5 5-CF 2.69% 3.04% 3.42% 4.25% 5.34% 0.50.1 9.4 5-CF 19.30% 28.36% 30.29% 30.94% 31.05% 0.5 0.5 4.0 5-CF 23.40%33.00% 34.29% 33.81% 33.55%

Example 10

In this example, the compositions of liposome Part A and B are shown inTable 19. The therapeutic liposome Part A (4460-090) contained 5-CF, asin Example 6. The therapeutic liposome was a non-stealth liposomecontaining 40 mol % cholesterol. The attacking liposome Part B(4460-075) contained 32 mole % TPGS and 16 mole % DOTAP, providingpositive charges to the attacking liposome. The results shown in Table20 and plotted in FIG. 10 indicate the total release of 5-CF from thetherapeutic liposome (4460-090) increased from ˜5% to ˜26% with theaddition of attacking liposome (4460-075) even when the pH value waschanged from 7.4 to 5.0. The results clearly show the total release ofliposome (4460-090) increased with the increasing initial amount of theattacking liposome.

TABLE 19 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic 4460-090DSPC/DSPG/Chol = 109.2 −17.4 liposome 48/12/40 Attacking 4460-075DPPC/Chol/ 80.3 11.4 liposome TPGS/DOTAP = 42/10/32/16

TABLE 20 In-vitro release of Dualsome in PBS 1X (pH = 5.0) TherapeuticAttacking Liposome Liposome PBS 1X Immediate (4460-090) (4460-075) (pH =5.0) Release Amount Amount Added Encapsulated after Release ReleaseRelease Release (mL) (mL) (mL) Therapeutics mixing at 1 hour at 6 hourat 24 hour at 48 hour 0.5 0.0 9.5 5-CF 0 0 1.18% 9.72% 25.60% 0.5 0.19.4 5-CF 3.61% 4.94% 5.40% 13.35% 23.37% 0.5 0.5 4.0 5-CF 11.88% 13.87%14.89% 21.92% 29.02%

Example 11

In this example, the compositions of liposome Part A and B are shown inTable 21. The therapeutic liposome (NLICOV003F-02) containedOxaliplatin, as in Example 1. The therapeutic liposome was a non-stealthliposome containing 10 mol % cholesterol. The attacking liposome(4460-104) contained 32 mol % TPGS and 16 mol % DOTAP, providingpositive charges to the attacking liposome. The results shown in Table22 and plotted in FIG. 11 indicate the total release of therapeuticliposome (COV003F-02) at 48-hours increased from ˜5% to ˜25% by additionof 20% of attacking liposome (4460-104) in PBS 1× at both pH 7.4 and pH5.0.

TABLE 21 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mV) Therapeutic NLICOV003E-DSPC/DSPG/ 83.6 −22.6 liposome 02 Chol = 70/20/10 Attacking 4460-104DPPC/Chol/ 76.5 5.89 liposome TPGS/DOTAP = 42/10/32/16

TABLE 22 In-vitro release of Dualsome in PBS 1X (pH = 5.0) TherapeuticAttacking Liposome Liposome Immediate (COV003F-02) (4460-104) PBS IXRelease Release Amount Amount Added Encapsulated after Release Releaseat 24 Release (mL) (mL) (mL) Therapeutics mixing at 1 hour at 6 hourhour at 48 hour 0.5 0.1 4.4, Oxaliplatin 13.59% 27.78% 28.95% 31.12%23.45% pH = 7.4 0.5 0.1 4.4, Oxaliplatin 12.93% 29.32% 28.37% 25.97%26.78% pH = 5.0

Example 12

In this example, the compositions of liposome Part A and B are shown inTable 23. The therapeutic liposome (NLI 4481101) contained cisplatin.The therapeutic liposome was a stealth liposome with 40 mol %cholesterol. The attacking liposome (4460-104) contained 32 mol % TPGSand 16 mol % DOTAP, providing positive charges to the attackingliposome. The results shown in Table 23 and plotted in FIG. 12 indicatethe release of therapeutic liposome (NLI4481101) after 48 hoursincreased from ˜1% to ˜5% by the addition of attacking liposome(4460-104) in PBS 1× at both pH 7.4 and pH 5.0. The results alsoindicate the cisplatin release of therapeutic liposome increased withthe increasing amount of the attacking liposome. The therapeuticliposome was a stealth liposome containing 40 mol % cholesterol. Theattacking liposome was oppositely charged, and contained 32 mol % TPGS.

TABLE 23 Dualsome Components Particle Size Zeta Composition (volumepotential Dualsome Name (mol %) nm) (mY) Therapeutic NL1 4481101HSPC/Chol/ 107.1 −0.99 liposome DSPE-PEG(2000) = 55/40/5 Attacking4460-104 DPPC/Chol/ 76.5 5.89 liposome TPGS/DOTAP = 42/10/32/16

TABLE 24 In-vitro release of Dualsome at PBS 1X (pH-7.4 and pH = 5.0)Therapeutic Attacking Liposome Liposome PBS IX Immediate (NL14481101)(4460-104) (pH = 7.4) Release Amount Amount Added Encapsulated afterRelease Release Release Release (mL) (mL) (mL) Therapeutics mixing at 1hour at 6 hour at 24 hour at 48 hour 0.5 0.0 4.5 Cisplatin 0 0 0 0 1.39%0.5 0.1 4.4 Cisplatin 1.55% 0 1.39% 1.98% 2.34% 0.5 0.5 4.0 Cisplatin2.61% 2.67% 3.32% 4.17% 4.70% Therapeutic Attacking Liposome LiposomePBS IX Immediate (NLICOV003F-02) (4460-075) (pH = 5.0) Release AmountAmount Added Encapsulated after Release Release Release Release (mL)(mL) (mL) Therapeutics mixing at 1 hour at 6 hour at 24 hour at 48 hour0.5 0.0 4.5 Cisplatin 0 0 0 0 1.56% 0.5 0.1 4.4 Cisplatin 1.64% 0 01.79% 2.56% 0.5 0.5 4.0 Cisplatin 2.68% 2.83% 3.18% 4.35% 5.50%

Although the foregoing invention has been described in some detail byway of illustration and example for purposes of clarity ofunderstanding, one of skill in the art will appreciate that certainchanges and modifications may be practiced within the scope of theappended claims. In addition, each reference provided herein isincorporated by reference in its entirety to the same extent as if eachreference was individually incorporated by reference. Where a conflictexists between the instant application and a reference provided herein,the instant application shall dominate.

What is claimed is:
 1. A first composition comprising a first liposomecomprising a therapeutic agent, wherein the therapeutic agent isselected from the group consisting of: cisplatin, oxaliplatin,carboplatin, gemcitibine, 5-fluorouracil, doxorubicin, and a taxane; anda second composition comprising a lipid nanoparticle comprising anon-ionic triggering agent for sequential or concurrent use with thefirst composition in delivering a therapeutic agent to a subject in needthereof, whereby release of the therapeutic agent from the liposomefollowing administration of the lipid nanoparticle is increased,relative to the release of the therapeutic agent from the liposomewithout administration of the lipid nanoparticle.
 2. The firstcomposition of claim 1, wherein the first liposome comprises one or morelipids selected from the group consisting of: a phospholipid, a steroid,and a cationic lipid.
 3. The first composition of claim 2, wherein thephospholipid is selected from the group consisting of: aphophatidylcholine, a phosphatidylglycerol, a phosphatidylethanolamine,a phosphatidylserine, a phosphatidylinositol, and a phosphatidic acid.4. The first composition of claim 3, wherein the phosphatidylcholine isdi stearoyl phosphatidyl choline (DSPC).
 5. The first composition ofclaim 3, wherein the phosphatidylglycerol is distearoyl phosphatidylglycerol (DSPG).
 6. The first composition of claim 3, wherein thephosphatidylethanolamine is DSPE-PEG(2000).
 7. The first composition ofclaim 2, wherein the steroid is cholesterol.
 8. The first composition ofclaim 2, wherein the cationic lipid isN-(1-)2,3-dioleoyloxy)propyl)-N,N,N-trimethylammonium chloride (DOTAP).9. The second composition of claim 1, wherein the lipid nanoparticle isselected from the group consisting of: a second liposome, a micelle, andmixtures thereof.
 10. The second composition of claim 9, wherein thelipid nanoparticle is a second liposome.
 11. The second composition ofclaim 10, wherein the second liposome comprises one or more lipidsselected from the group consisting of a phospholipid, a steroid, and acationic lipid.
 12. The second composition of claim 11, wherein thephospholipid is selected from the group consisting of: aphophatidylcholine, a phosphatidylglycerol, a phosphatidylethanolamine,a phosphatidylserine, a phosphatidylinositol, and a phosphatidic acid.13. The second composition of claim 12, wherein the phosphatidylcholineis dipalmitoyl phosphatidyl choline (DPPC).
 14. The second compositionof claim 11, wherein the steroid is cholesterol.
 15. The secondcomposition of claim 11, wherein the cationic lipid isN-(1-)2,3-dioleoyloxy)propyl)-N,N,N-trimethylammonium chloride (DOTAP).16. The second composition of claim 1, wherein the non-ionic triggeringagent is D-α-tocopheryl polyethylene glycol succinate (TPGS).
 17. Thefirst composition and second composition of claim 1, wherein the firstliposome comprises 40-80 mole % DSPC, 5-50 mole % cholesterol, 0-30 mole% DSPG, and 0-10 mole % DSPE-PEG(2000); and wherein the lipidnanoparticle is a second liposome comprising 40-70 mole % DPPC, 5-20mole % cholesterol, 0-20 mole % DOTAP, and 20-40 mole % TPGS.
 18. Thefirst composition and second composition of claim 1, wherein the subjectis human.
 19. The first composition and second composition of claim 1,wherein the lipid nanoparticle is administered after the first liposomeis administered and accumulated at a target site within the subject. 20.The first composition and second composition of claim 1, whereinadministration of the lipid nanoparticle increases the release of thetherapeutic agent from the first liposome at least 3-fold, 10-fold, or25-fold relative to the administration of the first liposome without useof the lipid nanoparticle.